How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,995 to $12,882Professionalmedian $219 · 10th to 90th $35 to $977
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,000.00 Median $3,801.89 Typical High $9,120.11 | Facility | None | $1,000.00 | $3,801.89 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $1,096.48 | Professional | None | $758.58 | $831.76 | $1,096.48 |
BCBS Texas Setting Facility Modifier None Typical Low $3,090.30 Median $6,606.93 Typical High $15,848.93 | Facility | None | $3,090.30 | $6,606.93 | $15,848.93 |
BCBS Texas Setting Professional Modifier None Typical Low $831.76 Median $1,047.13 Typical High $1,445.44 | Professional | None | $831.76 | $1,047.13 | $1,445.44 |
Christus Setting Facility Modifier None Typical Low $6,309.57 Median $6,309.57 Typical High $6,309.57 | Facility | None | $6,309.57 | $6,309.57 | $6,309.57 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $5,888.44 Typical High $8,511.38 | Facility | None | $954.99 | $5,888.44 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,023.29 Typical High $1,445.44 | Professional | None | $831.76 | $1,023.29 | $1,445.44 |
Health Smart Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Lucent Health Setting Professional Modifier None Typical Low $7,762.47 Median $7,762.47 Typical High $7,762.47 | Professional | None | $7,762.47 | $7,762.47 | $7,762.47 |
Moda Health Setting Facility Modifier None Typical Low $831.76 Median $2,511.89 Typical High $6,918.31 | Facility | None | $831.76 | $2,511.89 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $1,096.48 | Professional | None | $758.58 | $851.14 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $165.96 Typical High $758.58 | Professional | None | $32.36 | $165.96 | $758.58 |
Providence Setting Facility Modifier None Typical Low $912.01 Median $5,888.44 Typical High $8,709.64 | Facility | None | $912.01 | $5,888.44 | $8,709.64 |
Providence Setting Professional Modifier None Typical Low $831.76 Median $1,023.29 Typical High $1,445.44 | Professional | None | $831.76 | $1,023.29 | $1,445.44 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $5,248.07 Typical High $12,302.69 | Facility | None | $2,137.96 | $5,248.07 | $12,302.69 |
United Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $1,412.54 | Professional | None | $707.95 | $912.01 | $1,412.54 |
Wellpoint Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
12 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $380.19 Median $416.87 Typical High $478.63 | Professional | 52 · Reduced service | $380.19 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $165.96 Typical High $190.55 | Professional | 53 · Discontinued | $151.36 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $630.96 Typical High $724.44 | Professional | 54 · Surgery only | $562.34 | $630.96 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $125.89 Typical High $144.54 | Professional | 55 · Aftercare only | $112.20 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $83.18 Typical High $95.50 | Professional | 56 · Pre-op care only | $75.86 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $588.84 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $524.81 | $588.84 | $676.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $380.19 Median $416.87 Typical High $478.63 | Professional | 52 · Reduced service | $380.19 | $416.87 | $478.63 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $165.96 Typical High $190.55 | Professional | 53 · Discontinued | $151.36 | $165.96 | $190.55 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $630.96 Typical High $707.95 | Professional | 54 · Surgery only | $562.34 | $630.96 | $707.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $125.89 Typical High $141.25 | Professional | 55 · Aftercare only | $112.20 | $125.89 | $141.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $83.18 Typical High $95.50 | Professional | 56 · Pre-op care only | $75.86 | $83.18 | $95.50 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $588.84 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $524.81 | $588.84 | $660.69 |
Where Texas sits
The same service costs 7.9 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Texas· 51st of 51
$468
AK $3,715TX $468
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.